ArticleThe international journal of behavioral nutrition and physical activity2015
Use of the Environment and Policy Evaluation and Observation as a Self-Report Instrument (EPAO-SR) to measure nutrition and physical activity environments in child care settings: validity and reliability evidence.
Article in The international journal of behavioral nutrition and physical activity, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06810570 (Understanding the Impact of Interactive Electronic Devices on Young Children's Development and Health), which is not on this map. Cited by 51 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Understanding the Impact of Interactive Electronic Devices on Young Children's Development and Health: the iKids Study
Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Measurement of availability and accessibility of food among youth: a systematic review of methodological studies.The international journal of behavioral nutrition and physical activity · 2017Pooled it
- Evaluating the Sustaining Play, Sustaining Health programme in Australian early childhood education and care services: a pilot randomized controlled trial.Health promotion international · 2025Trial
- Trial
- Impact of a multi-component implementation strategy to increase outdoor free play opportunities in early childhood education and care (ECEC) services: the get outside get active (GOGA) randomised controlled trial.The international journal of behavioral nutrition and physical activity · 2025Trial
- Play Active physical activity policy intervention and implementation support in early childhood education and care: results from a pragmatic cluster randomised trial.The international journal of behavioral nutrition and physical activity · 2023Trial
- Feasibility of a Web-Based Implementation Intervention to Improve Child Dietary Intake in Early Childhood Education and Care: Pilot Randomized Controlled Trial.Journal of medical Internet research · 2021Trial
- Impact of scheduling multiple outdoor free-play periods in childcare on child moderate-to-vigorous physical activity: a cluster randomised trial.The international journal of behavioral nutrition and physical activity · 2018Trial
- Translating a child care based intervention for online delivery: development and randomized pilot study of Go NAPSACC.BMC public health · 2017Trial
- Trial
- Supporting responsive feeding in early childhood education centres: a process evaluation of the CELEBRATE feeding intervention using the RE-AIM framework.Health education research · 2026Article
- CELEBRATE Feeding: Impacts of a responsive feeding behaviour change coaching intervention in child care settings.Journal of nutritional science · 2026Article
- Article
- Schoolyard Level Inventory for Describing the Environment: Linking High-Resolution Spatiotemporal Data to the Physical Environment to Understand Children's Physical Activity Behaviors.The Journal of school health · 2025Article
- Assessing the implementation of healthy eating and physical activity policies and practices in Early Childhood Education and Care in New South Wales, Australia: A cross-sectional study.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2025Article
- Article
- Physical Activity-Related Practices and Psychosocial Factors of Childcare Educators: A Latent Profile Analysis.Children (Basel, Switzerland) · 2024Article
- Advancing assessment of responsive feeding environments and practices in child care.Journal of nutritional science · 2024Article
- Factors associated with physical activity policy and practice implementation in British Columbia's childcare settings: a longitudinal study.BMC public health · 2023Article
- A Pilot Randomised Controlled Trial to Increase the Sustainment of an Indoor-Outdoor-Free-Play Program in Early Childhood Education and Care Services: A Study Protocol for the Sustaining Play, Sustaining Health (SPSH) Trial.International journal of environmental research and public health · 2023Article
- Kindergarten Affordances for Physical Activity and Preschoolers' Motor and Social-Emotional Competence.Children (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundEarly care and education (ECE) centers are important settings influencing young children's diet and physical activity (PA) behaviors. To better understand their impact on diet and PA behaviors as well as to evaluate public health programs aimed at ECE settings, we developed and tested the Environment and Policy Assessment and Observation - Self-Report (EPAO-SR), a self-administered version of the previously validated, researcher-administered EPAO.
methodsDevelopment of the EPAO-SR instrument included modification of items from the EPAO, community advisory group and expert review, and cognitive interviews with center directors and classroom teachers. Reliability and validity data were collected across 4 days in 3-5 year old classrooms in 50 ECE centers in North Carolina. Center teachers and directors completed relevant portions of the EPAO-SR on multiple days according to a standardized protocol, and trained data collectors completed the EPAO for 4 days in the centers. Reliability and validity statistics calculated included percent agreement, kappa, correlation coefficients, coefficients of variation, deviations, mean differences, and intraclass correlation coefficients (ICC), depending on the response option of the item.
resultsData demonstrated a range of reliability and validity evidence for the EPAO-SR instrument. Reporting from directors and classroom teachers was consistent and similar to the observational data. Items that produced strongest reliability and validity estimates included beverages served, outside time, and physical activity equipment, while items such as whole grains served and amount of teacher-led PA had lower reliability (observation and self-report) and validity estimates. To overcome lower reliability and validity estimates, some items need administration on multiple days.
conclusionsThis study demonstrated appropriate reliability and validity evidence for use of the EPAO-SR in the field. The self-administered EPAO-SR is an advancement of the measurement of ECE settings and can be used by researchers and practitioners to assess the nutrition and physical activity environments of ECE settings.
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